ImPlementation REsearCh to DEvelop interventions for People Living with HIV (PRECluDE)
What was the goal of PRECluDE?
The ImPlementation REsearCh to DEvelop interventions for People Living with HIV (PRECluDE) consortium was funded to address barriers to implementing data-backed interventions designed to prevent, treat, and manage heart, lung, blood, and sleep (HLBS) conditions in people living with HIV. Improving the uptake of these interventions has been vitally important, given the increasing prevalence of HLBS conditions among older people with HIV, as well as the rise in HLBS-related risk factors in that population. The five research studies funded through PRECluDE used innovative implementation frameworks, with strategies targeting active engagement of organizations, HIV clinicians, and people living with HIV to advance HLBS care and disseminate HIV interventions in diverse settings. Researchers hope the findings will lead to effective ways to improve HLBS-related health outcomes and reduce disparities among people with HIV.
AT A GLANCE
- The PRECluDE consortium began in 2017 and concluded at the end of 2024. Some findings have been published; others will be published when all analyses are final.
- PRECluDE supported five studies across the United States. The studies tested novel strategies to expand HLBS interventions for people with HIV.
- PRECluDE findings may help identify ways to reduce the burden of HLBS risk factors and conditions at organizational, provider, community, and individual levels.
Why was the PRECluDE consortium important?
In the decades before PRECluDE launched, new cases of HIV infection decreased overall in the United States. People with HIV were also living longer, thanks to improved treatment options and recommendations. However, in looking at disease burden, researchers discovered profound disparities between different regions of the country and between people of different races and ethnicities. They also discovered that people with HIV had a higher risk of developing certain HLBS conditions than those without HIV.
While scientists had developed effective risk stratification tools, screening methods, and treatment regimens for people with HLBS conditions, these interventions had not always been used for people with HIV. The PRECluDE consortium aimed to bridge that implementation gap by bringing effective, evidence-based practices for HLBS conditions to diverse settings. Many funding opportunities are still available for researchers who want to study HIV-related HLBS risk factors and conditions.
The PRECluDE consortium has generated critical knowledge aimed at supporting and improving the health of people with HIV, even as study analyses continue. The hope is that these findings will influence future clinical care guidelines, medical recommendations, and organizational policies.
The PRECluDE consortium extended to areas throughout the United States. (Figure from a research paper.)
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ImPlementation REsearCh to DEvelop interventions for People Living with HIV (PRECluDE)
What studies were a part of PRECluDE?
The PRECluDE consortium was represented by five studies, described below. Each study developed and tested novel strategies for introducing HLBS interventions within healthcare settings for people with HIV. Learn about each PRECluDE study below.
Read about:
GREAT 2 (Implementation Research: Translating the ABCS into HIV Care)
- PI: Kevin Fiscella, M.D. M.P.H.
- Institution: University of Rochester
- Contact: Kevin_Fiscella@urmc.rochester.edu
The GREAT 2 study designed clinical trials to evaluate the impact of training clinicians and patients to use ABCS interventions (aspirin use, blood pressure control, cholesterol control, and smoking cessation) to reduce multilevel cardiovascular disease risk for people with HIV.
High-quality COPD Care for People With Immune Dysfunction Through Proactive E-consults (ACHIEVE)
- PI: David H. Au, M.D., M.S.; Kristina A. Crothers, M.D.; Christian D. Helfrich, Ph.D., M.P.H.
- Institution: VA Puget Sound Health Care System
- Contact: crothk@uw.edu
The ACHIEVE study developed and tested a specialist-initiated virtual consultation tool meant to improve the diagnosis, treatment, and management of chronic obstructive pulmonary disease (COPD) for people with HIV at seven U.S. Department of Veterans Affairs sites. The study aimed to promote effective, evidence-based care strategies and reduce the use of inappropriate therapies to manage COPD for people with HIV.
A Nurse-led Intervention to Extend the HIV Treatment Cascade for Cardiovascular Disease Prevention (EXTRA-CVD)
- PI: Chris Longenecker, M.D.
- Institution: University of Washington
- Contact: ctlongen@uw.edu
The EXTRA-CVD study was a nurse-led randomized interventional clinical trial. The investigative team developed and tested a multicomponent strategy composed of care coordination, education/awareness efforts, and medication adherence tracking to reduce high blood pressure and cholesterol among people with HIV.
Healing Our Hearts Minds and Bodies: CVD Reduction in Persons With HIV (HHMB)
- PI: Gail Wyatt, Ph.D.
- Institution: University of California, Los Angeles
- Contact: gwyatt@mednet.ucla.edu
The HHMB study developed and tested culturally congruent mental health interventions within the HIV continuum of care to better address trauma and associated cardiovascular disease risks for African Americans and Latinos in safety net clinics serving people with HIV.
INcreasing Statin Prescribing in HIV Behavioral Economics REsearch (INSPIRE)
- PI: Allison L. Diamant, M.D., M.S.H.S.
- Institution: University of California, Los Angeles
- Contact: adiamant@mednet.ucla.edu
The INSPIRE study developed and tested an intervention to enhance adherence to a guideline-based recommended use of statins to lower the risk of heart diseases in people with HIV. The intervention included tailored education for clinic leaders, providers, and patients, as well as feedback to providers intended to increase their confidence to prescribe statins.
What are the key findings of PRECluDE?
The EXTRA-CVD PRECluDE study found that an extended care program — led by nurses providing participants with extra support at home — improved blood pressure and cholesterol levels for people with HIV.
Researchers from other PRECluDE studies are analyzing data and publishing findings. Explore publications related to PRECluDE.
PRECluDE is linked to the following NHLBI strategic priorities:
- Investigate factors that account for differences in health among populations
- Develop and optimize novel diagnostic and therapeutic strategies to prevent, treat, and cure HLBS diseases
- Optimize clinical and implementation research to improve health and reduce disease
- Further develop, diversify, and sustain a scientific workforce capable of accomplishing the NHLBI’s mission